Application of biomaterials and nanotechnology in corneal tissue engineering

Abstract

Corneal diseases are among the most common causes of blindness worldwide. Regardless of the etiology, corneal opacity- or globe integrity-threatening conditions may necessitate corneal replacement procedures. Several procedure types are currently available to address these issues, based on the complexity and extent of injury. Corneal allograft or keratoplasty is considered to be first-line treatment in many cases. However, a significant proportion of the world’s population are reported to have no access to this option due to limitations in donor preparation. Thus, providing an appropriate, safe, and efficient synthetic implant (e.g., artificial cornea) may revolutionize this field. Nanotechnology, with its potential applications, has garnered a lot of recent attention in this area, however, there is seemingly a long way to go. This narrative review provides a brief overview of the therapeutic interventions for corneal pathologies, followed by a summary of current biomaterials used in corneal regeneration and a discussion of the nanotechnologies that can aid in the production of superior implants.

Replace or Regenerate? Diverse Approaches to Biomaterials for Treating Corneal Lesions

“…The use of PMMA in the back plate can be replaced by medical-grade titanium: The lack of transparency could have a negative impact, as it shields stray light. A considerable advantage is due to the decrease in the incidence of retroprosthetic membrane formation from 30% to 13% when using a titanium plate combined with recent anti-inflammatory innovations [46,47], which occurs by far in 18-55% of cases [48]. However, the use of titanium or PMMA remains controversial, and the choice of the material mainly depends on surgeons' experience [40].…”

“…Silk fibroin is another promising biomaterial for the production of corneal scaffolds [6]: It is non-immunogenic and allows for easy production of high-resolution patterns via lithographic techniques [36]. In order to improve the structural integrity of the silk-based scaffolds, their cell adhesion/proliferation, and cell migration, several studies managed to blend fibroin-based scaffolds with several other biomaterials, including arginyl-glycylaspartic acid (RGD) peptide [86], poly-D-lysine (PDL) [87], aloe vera [88], β-carotene [89], lysophosphatidic acid [90], chitosan [91], and collagen obtaining significant results [48]. These characteristics make silk fibroin an ideal material to use as a substrate for the construction of the cornea and other tissues [36].…”

Novel Correlation between TGF-β1/-β3 and Hormone Receptors in the Human Corneal Stroma

“…This leads to improper extracellular matrix (ECM) deposition, corneal fibrosis, and ultimately impaired vision [3,10,16,17]. Corneal transplantation [18][19][20] remains the most effective treatment to restore the injured cornea. Studies report high success rates of full thickness corneal transplantation (80% to ~96%), with up to 20% [18,21,22] post-operative (post-op) complications.…”

“…Corneal transplantation [18][19][20] remains the most effective treatment to restore the injured cornea. Studies report high success rates of full thickness corneal transplantation (80% to ~96%), with up to 20% [18,21,22] post-operative (post-op) complications. Other complications include donor cornea rejection, cataract formation, and vascularization [18,23,24].…”

“…Studies report high success rates of full thickness corneal transplantation (80% to ~96%), with up to 20% [18,21,22] post-operative (post-op) complications. Other complications include donor cornea rejection, cataract formation, and vascularization [18,23,24]. Sex as a biological variable (SABV) in the context of corneal fibrosis and its treatment(s) is largely unexplored.…”